Public health funding using a determinants of health approach: Learnings from the field

Funding for public health ideally should address those conditions that make populations healthier. While there is a plethora of literature on health care system funding formulas and approaches, there is little specific public health literature.

In Nova Scotia Canada, health care is delivered through nine district health authorities. The provincial distribution of funding to the district health authorities for public health has historically been based on administrative units, per capita funding, and/or political/community demand. The Department of Health Promotion and Protection recognized that addressing the social determinants of health would have significant impact on the health of populations and that a funding approach that incorporates social determinants would be preferable to the historical funding approaches.

In 2006, a funding approach was developed in collaboration with the district health authorities. The funding approach implemented was based on three components: base amount, population and social determinants of health. The indicators used for the social determinants component were: education, geography, income and self rated health. Provincially, all new funding over the next 2 fiscal years utilized the funding approach.

In 2009 an evaluation of the funding approach was undertaken to assess use, user satisfaction, strengths and challenges of the funding approach used by public health. The abstract presentation will focus on the methodology of development, the results of the evaluation of the funding approach implemented and the learnings from public health to the broader health care system.